Cabir Yüksel

Association of ABO blood group and risk of lung cancer in a multicenter study in Turkey.

BACKGROUND The ABO blood groups and Rh factor may affect the risk of lung cancer. MATERIALS AND METHODS We analyzed 2,044 lung cancer patients with serologically confirmed ABO/Rh blood group. A group of 3,022,883 healthy blood donors of Turkish Red Crescent was identified as a control group. We compared the distributions of ABO/Rh blood group between them. RESULTS The median age was 62 years (range: 17-90). There was a clear male predominance (84% vs. 16%). Overall distributions of ABO blood groups were significantly different between patients and controls (p=0.01). There were also significant differences between patients and controls with respect to Rh positive vs. Rh negative (p=0.04) and O vs. non-O (p=0.002). There were no statistically significant differences of blood groups with respect to sex, age, or histology. CONCLUSIONS In the study population, ABO blood types were associated with the lung cancer. Having non-O blood type and Rh-negative feature increased the risk of lung cancer. However, further prospective studies are necessary to define the mechanisms by which ABO blood type may influence the lung cancer risk.

Benign Localized Fibrous Tumor of the Pleura: Report of 25 New Cases

OBJECTIVE Benign localized fibrous tumors (BLFT) of the pleura are very rare slow-growing neoplasms that generally have a favorable prognosis. The aim of this manuscript is to evaluate the predictors of outcome with the review of the literature in a series of 25 patients with BLFT. METHODS Between January 1985 and November 2009, 25 patients underwent an operation due to BLFT. Of these patients, 14 (56%) were male; mean age was 41.1 (25 to 64) years. All patients underwent thoracotomy. Left thoracotomy approach was used in 16 patients. The mass lesions were totally excised. The histopathological examinations were performed with hematoxylin-eosin and immunohistochemical staining methods. RESULTS Of the patients, 18 (72%) were symptomatic. Symptoms were cough in 36%, shortness of breath in 32%, and chest pain in 20% of the patients. One patient (4%) appeared to have some symptoms (pain and swelling of the joints) associated with pulmonary osteoarthropathy. Seven patients (28%) underwent an operation due to mass lesion detected at routine control visits. None of the patients had a history of exposure to asbestos. Radiological investigations revealed 16 (64%) mass lesions in the left. Of the lesions found on exploration, 5 (20%) were intrapulmonary localized lesion without pedicle and 20 were pedicled. Of the pedicled masses, 5 were connected to parietal pleura and 15 to visceral pleura and all were intrathoracic extrapulmonary localized lesions. Eight (32%) lesions connected to left lower lobe. Additionally, three pedicled lesions were located in the lung fissure. Pedicled lesions were totally excised together with their pedicles. Intraparenchymal mass lesions were resected using wedge resection. The diameter of the resected masses was ranging between 3 and 22 cm (mean: 8.7). Macroscopically, all were encapsulated with a homogeneous cut surface. Intraoperative mortality and morbidity was not observed. The average hospitalization duration for all patients was 8.6 days (5 to 12). The mean follow-up was 33.6 (9 to 142) months with no recurrence. CONCLUSIONS Benign localized fibrous tumors are uncommon and treated by surgical means. According to our data obtained from literature review, clinicians should be aware of recurrence possibility even after complete resection of benign localized fibrous tumor and the risk of malign transformation.

The Outcome of Bifocal Surgical Resection in Non-Small Cell Lung Cancer with Synchronous Brain Metastases: Results of a Single Center Retrospective Study

BACKGROUND The reported median survival in patients with non-small cell lung cancer (NSCLC) metastases to the brain varies from 3 to 12 months with combined treatment modalities. Bifocal surgical resection of synchronous brain metastasis and primary NSCLC has not been reported widely, and there have been only a small number of articles published in the literature. The aim of this retrospective study was to evaluate the prognostic factors among patients undergoing bifocal surgical resection. MATERIALS AND METHODS We retrospectively analyzed 28 patients who had a solitary metastatic brain lesion at the time of diagnosis, and underwent synchronous surgical resection of the brain metastasis and primary lung tumor. Survival time was measured in all the patients from the date of craniotomy until death or the most recent date of follow-up for those still surviving. RESULTS Mean age was 53 years. The mean length of follow-up was 23.6 (4-69) months. The overall survival rates were 79, 42, and 8% at the 1st, 2nd, and 5th years, respectively. The median length of survival was 24 ± 3.8 months. The median survival was found to be statistically significantly lower for the stage T3 tumors when compared with both stage T1 and T2 tumors (p = 0.037). CONCLUSION NSCLC patients with resectable solitary cranial metastasis, low locoregional stage (stages IA, IB, IIA) in which T3 status is counted out, with no mediastinal lymph node involvement or any other extrathoracic spread will mostly benefit from consecutive complete resection of both tumors and are supposed to have a better survival.

Resection of Esophageal Carcinoma During Pregnancy

Esophageal carcinoma diagnosed during pregnancy is a rare occurrence. A 26-year-old pregnant patient was referred to our hospital with dysphagia. A thorough examination showed a tumor in the esophagus. Laparotomy, thoracotomy, and cervical exploration were performed. There are only 2 cases reported in the literature about esophageal carcinoma diagnosed during pregnancy and treated surgically. However, ethical dilemmas arise in managing such situations. Here we report a case of esophageal squamous cell carcinoma diagnosed at 27 weeks of gestation in which surgical resection was performed successfully.

The Role of Pleural Fluid Procalcitonin Level in the Diagnosis of Parapneumonic Pleural Effusion

Amaç: Prokalsitonin, infeksiyöz hastalıkları noninfeksiyöz hastalıklardan ayrımda diğer infeksiyon belirteçlerine göre erken ve oldukça yüksek özgüllükte sonuç verebilmektedir. Yapılan bazı çalışmalarda, plevral sıvı prokalsitonin (PCT) düzeyinin parapnömonik efüzyon (PPE)’da diğer nedenlere bağlı sıvılara göre daha yüksek olduğu bulunmuş ve tanıda yararlı bir belirteç olduğu bildirilmiştir. Bu çalışmada amaç, plevral sıvı PCT düzeyinin PPE tanısındaki rolünü araştırmaktır.

MYASTHENIA GRAVIS AND THYMECTOMY

Myastenia gravis (MG) anormal nöromusküler iletimin neden olduğu otoimmün bir hastalıktır. Blalock’un MG için bildirdiği ilk başarılı timektomiden beri timusun cerrahi olarak çıkarılması hastalık için alternatif bir tedavi yöntemi olmuştur. Fakat timektominin zamanlaması, hangi olgularda uygulanması gerektiği ve cerrahi yaklaşım şekli üzerinde tartışmalar devam etmektedir. Timoma varlığında cerrahi endikasyon nettir. Nontimomatöz jeneralize MG’de timektomi konusunda konsensus bulunmakla birlikte, oküler MG gibi hastalarda cerrahinin yeri hala sorgulanmaktadır. MG için ideal cerrahi yaklaşımın tanımlanmasında hala ciddi tartışmalar mevcuttur. Her biri kendi içinde varyasyonlar gösteren çok sayıda cerrahi teknik (transservikal, videoskopik, transsternal ve maksimal) tanımlanmış ve önerilmiştir. Hangi yöntemin daha faydalı olduğunu göstermenin en ideal yöntemi randomize çalışmalar yapılmasıdır. MG’li hastaların preoperatif değerlendirmesinde hastalığın son dönemdeki seyri, etkilenen kas grubu, uygulanan ilaç tedavisi ve yandaş hastalıklara odaklanılmalı, solunum fonksiyon testleri incelenmelidir. MG için timektomi uygulanacak hastalarda preoperatif, intraoperatif ve postoperatif dönemde, anestezi, nöroloji ve cerrahi ekibin birlikte çalışması mutlak önemlidir. Günümüzde mevcut ve uygun analiz edilmiş kanıtlar doğrultusunda timektominin nontimomatöz otoimmün MG etkili bir tedavi olduğu anlaşılmaktadır. Uygun cerrahi yaklaşım ister açık transsternal isterse minimal invaziv uygulansın komplet rezeksiyonu ve stabil remisyonu hedeflemelidir.

Özofagus Kanserinde Helicobacter Pylori ve Barret Özofagus’un Rolü = The Role Of Helicobacter Pylori And Barretts Esophagus In Esophageal Cancer

Ozofagus kanserlerinin gelisiminde; sigara ve alkol kullanimi, beslenme ile ilgili etkenler, genetik ve cevresel faktorler ve bazi predispozan hastaliklar rol almaktadir. Peptik veya kostik ozofajit, Barret ozofagus, Plummer Winson Sendromu, akalazya, tylosis, gluten enteropatisi gibi hastaliklar predispozan hastaliklardir. Ozofagus kanseri olusumunda Barret ozofagusun onemli bir predispozan faktor oldugu tum otorler tarafindan kabul edilmektedir. Helicobacter pylori’nin ise predispozan rol aldigini belirten yayinlar olmakla birlikte bunun tersini iddia eden gorusler de ortaya atilmistir